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KMID : 0356720010170060324
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Journal of the Korean Society of Coloproctology
2001 Volume.17 No. 6 p.324 ~ p.331
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The Effects and Surgical Morbidity of Preoperative Combined Chemoradiotherapy for Locally Advanced Rectal Cancer
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Jung Ji-Eun
Kim Kab-Tae
Chung Eul-Sam
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Abstract
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Purpose: The aim of this study is to evaluate the effectiveness and surgical morbidity of preoperative chemoradiotherapy for locally advanced rectal cancer.
Methods: Between December 1997 and March 2000, 36 patients with locally advanced rectal cancer (clinical stage II or III) were treated with preoperative chemoradiation: bolus i.v. leucovorin, 20 ㎎/㎡, plus 24-h continuous infusion i.v. 5-Fluorouracil, 425 ㎎/㎡, Days 1∼5, 29∼33 and concurrent radiotherapy 4,500 cGy over 5 weeks. Surgery was performed 4∼8 weeks after completion of the chemoradiotherapy.
Results: Grade 3∼4 toxicity during chemoradiotherapy was low: hematological toxicities 2.8%, gastro-intestinal toxicities 5.5% and skin toxicities 8.3%. Complete response rate was 16.7% and partial response rate was 47.2%, the rate of downstaging for tumor was 65.5%. The overall rate of resectability was 94.1%. In 13 of 22 (59.1%) patients planned APR, the sphincter was preserved. The overall rate of surgical morbidity was 23.5%, but there was no postoperative mortality. One patient needed a reoperation because a complication may be associated with preoperative chemoradiotherapy.
Conclusions: Preoperative chemoradiotherapy for locally advanced rectal cancer seems to afford some potential advantages: patients are able to tolerate higher chemotherapy doses with low toxicities; tumor downstaging and resectability rates are high; sphincter preservation is feasible; But perioperative morbidity has generally tolerable complications. And so we recommend the preoperative chemoradiotherapy may be one of the best treatments for locally advanced rectal cancer.
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KEYWORD
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Rectal cancer, Locally advanced, Preoperative chemoradiotherapy
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